Melman A, Gingell J C
Department of Urology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA.
J Urol. 1999 Jan;161(1):5-11.
Published studies on the epidemiology of erectile dysfunction and the physiology/ pathophysiology of erectile function are reviewed.
A literature search of more than 400 studies of the epidemiology and pathophysiology of impotence and erectile dysfunction published during the last 3 decades was conducted and the most pertinent articles are discussed.
It has been estimated that the prevalence of erectile dysfunction of all degrees is 52% in men 40 to 70 years old, with higher rates in those older than 70 years. Erectile dysfunction has a significant negative impact on quality of life. Risk factors for erectile dysfunction include aging, chronic illnesses, various medications and cigarette smoking. A nitric oxide/cyclic guanosine monophosphate mechanism has an important role in mediating the corporal smooth muscle relaxation necessary for erectile function. Other mechanisms involving neuropeptides, gap junctions and ion channels also may modulate corporal smooth muscle tone. Erectile dysfunction can be due to vasculogenic, neurogenic, hormonal and/or psychogenic factors as well as alterations in the nitric oxide/cyclic guanosine monophosphate pathway or other regulatory mechanisms, resulting in an imbalance in corporal smooth muscle contraction and relaxation.
Erectile dysfunction is a common condition associated with aging, chronic illnesses and various modifiable risk factors. Normal penile erection is a hemodynamic process that is dependent on corporal smooth muscle relaxation mediated by parasympathetic neurotransmission, nitric oxide, and possibly other regulatory factors and electrophysiological events. As more knowledge is gained of the physiology and regulatory factors that mediate normal erectile function, the mechanisms involved in the pathophysiology of erectile dysfunction should be further elucidated.
对已发表的关于勃起功能障碍的流行病学以及勃起功能的生理学/病理生理学的研究进行综述。
对过去三十年发表的400多项关于阳痿和勃起功能障碍的流行病学及病理生理学的研究进行文献检索，并讨论最相关的文章。
据估计，40至70岁男性中各种程度勃起功能障碍的患病率为52%，70岁以上男性的患病率更高。勃起功能障碍对生活质量有显著负面影响。勃起功能障碍的危险因素包括衰老、慢性疾病、各种药物和吸烟。一氧化氮/环磷酸鸟苷机制在介导勃起功能所需的海绵体平滑肌松弛中起重要作用。涉及神经肽、缝隙连接和离子通道的其他机制也可能调节海绵体平滑肌张力。勃起功能障碍可能由血管源性、神经源性、激素性和/或心理性因素以及一氧化氮/环磷酸鸟苷途径或其他调节机制的改变引起，导致海绵体平滑肌收缩和松弛失衡。
勃起功能障碍是一种与衰老、慢性疾病和各种可改变的危险因素相关的常见病症。正常阴茎勃起是一个血流动力学过程，依赖于由副交感神经传递、一氧化氮以及可能的其他调节因素和电生理事件介导的海绵体平滑肌松弛。随着对介导正常勃起功能的生理学和调节因素的了解越来越多，勃起功能障碍病理生理学中涉及的机制应得到进一步阐明。
